Provider Demographics
NPI:1013789239
Name:GADDIS, ANNE KRISTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE KRISTINE
Middle Name:
Last Name:GADDIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 THE GRN STE 12999
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:302-217-6221
Mailing Address - Fax:
Practice Address - Street 1:VIA LUDOVICO LAZZARO ZAMENHOF, 817
Practice Address - Street 2:
Practice Address - City:VICENZA
Practice Address - State:VI
Practice Address - Zip Code:36100
Practice Address - Country:IT
Practice Address - Phone:302-217-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005972103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist